The Current AMA Executive Summary”Health in the United States: Health Care Trends” Comprises both a little hope and a lot of gloom.
By 2050 the section of the population over 65 will double from now to 83.7 million. It follows that the incidence of chronic illness will rise dramatically. Since 1990, smoking has decreased from 29.5percent to 18.1percent of the adult population. Probably as a consequence, stroke has declined 34 percent, heart disease 27 percent, and cancer 17%. This sounds great but…
Since 1990, the obesity rate in adults (defined as BMI over 30) has risen from 12 percent to 29.6%. During the exact same time diabetes rose from 4.4% to 10% of adults. The CDC predicts that by 2050, thirty percent of adults will suffer diabetes. Because of this, obesity has become the major cause of heart attacks. Physical inactivity is a significant reason. Just 21 percent of adults get the US Department of Health and Human Services recommended 150 minutes of exercise each week. Many companies now offer health programs that provide financial rewards for healthy behaviours. This might be a significant step in the right direction. Needless to say, punitive actions denying health insurance to the morbidly obese or uncontrolled diabetics may also be coming, particularly if the federal government leaves the medical insurance business to private businesses.
The AMA reports that primary care doctors are closing their practices and retiring early or moving to non-clinical areas like insurance, quality management, the pharmaceutical industry as well as medical informatics. Since the demand for health services will increase dramatically, a growing percentage of primary care will be provided by PAs and Nurse Practitioners. I expect they’ve increasing independence. This isn’t always a bad thing, a number of these caregivers are excellent and provide compassionate and comprehensive care. A potential byproduct of this trend might be an increase in demand for referrals and subspecialty care, like sending diabetics to endocrinologists and COPD patients to lung experts.
A dystopian future looms at which the cost of health care is greater than our resources can handle. In this rather frightening scenario, someone might need to be refused services, likely either the helpless or people who refuse to embrace mandatory health guidelines. It’s not come to that yet. We still have the time to make recommended changes in diet and activity. Bear in mind, who could have predicted everyone would stop smoking?